When should you start the epidural?

This type of analgesia can be started at any time during labour. For the greatest benefit it needs to be done early enough to be useful. The normal dosage of the painkillers used will not make the baby sleepy or slow to breathe at birth as some of the other strong pain relief injections used in labour may do. 

Which epidural is best?

Certain factors play a part in the anaesthetist's decision process. The pain relief used before asking for an epidural is important. Mobile epidurals cannot be given within 3 hours of Diamorphine or Pethidine injections. If you have a preference, please feel free to discuss it with the anaesthetist or midwife.

Advantages and disadvantages of epidurals

  • An epidural gives much more complete relief from discomfort in labour than any current alternative.
  • Normally epidural analgesia is straightforward and very effective, with little risk of harmful effects.
  • Epidurals may cause low blood pressure and a drip is routinely set up before they are commenced.
  • These methods may not always work in a satisfactory way. In this case it may be possible to switch from the mobile epidural dose to a standard epidural, but it may be necessary to reposition the epidural.

Recent research has demonstrated that you are no more likely to get backache after having an epidural for labour than if you have your baby without an epidural.

Very rarely a slow leak of spinal fluid can occur afterwards and may cause a headache, meaning you have to lie flat for a day or so until the leak seals itself. Very occasionally a second injection has to be used to seal the leak.

Despite the few disadvantages, most women find that an epidural makes their labour much more enjoyable.

Emergency caesarean section

It may sometimes be possible (depending upon assessment at the time) for a working epidural to be used for emergency Caesarean section. However a general anaesthetic may be necessary.

Assisted delivery - forceps or ventouse

A functioning epidural can be used to make an assisted delivery a pain free experience should it be necessary.

Obtaining the pain relief you want

Advice on the various techniques, with their pros and cons, can be obtained from your midwife. If you have a preference you can ask for whichever of the methods of pain relief you think will suit you best.

If you have any health problems please mention this to your midwife or doctor early in your pregnancy.Occasionally there may be medical reasons why one of the methods is not suitable for you. If this is the case, the reason, and the alternatives that are available, will be explained to you.

If you suffer from any medical condition, please mention it to antenatal clinic staff. They can then decide whether it is necessary for you to be seen by an anaesthetist before you are in labour.

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